Childhood obesity has reached epidemic proportions worldwide and its prevalence is increasing e.g. In america, direct measures of body mass and height obtained through the national health and nutrition examination survey (nhanes) indicate that approximately 15% of 6 – 19 year olds were classified as overweight in 1999 – 2000. This value was up approximately 5% from 1988 to 1994 (ogden cl,p1728)

All of the literature refers to similar statistics regarding childhood obesity.

The list below gives some examples of the data available from the different sources.

• obesity has more than doubled between 1990 and 2000 in britain.
• one in 10 six year olds (8.5%) are obese.
• one in six (15%) 15 year olds is obese.
• if the current trends continue, one fifth of boys and one third of girls will be obese by 2020.

Obesity is measured using the body mass index (bmi) for an individual. This is measured through a calculation relating height to weight and age, and there are agreed figures for obesity.

2 INTRODUCTION

Obesity is measured using the body mass index (BMI), for an individual. This is measured through a calculation relating height to weight and age, and there are agreed figures for obesity.

Childhood obesity is becoming a worldwide problem. All the articles that were reviewed highlight the rising levels but also look into health and school policies to tackle the problem.

All the articles also support family focused approach for influencing dietary habits of the children, as well as support and involvement of the communities.

Diseases which were only diagnosed in adults are now also diagnosed in the children, e.g. Heart diseases, diabetes, some cancers, hypertension and dyslipidemia. (vitale, e: 2010)

Children are not fully responsible for their own health choices and rely on adults to protect and nurture them. (vitale, e : 2010).

In South Africa overweight and obesity are not restricted to only one population group or socio-economic group. The South African youth risk behaviour study (www.mrc.ac.za/healthpromotion.htm) showed that overweight and obesity are very common in all age groups.

3 ARTICLES REVIEWED

Vitale, E. (2010). A School Nursing approach to childhood obesity: an early chronic inflammatory disease. Immunopharmacology and Immunotoxicology, 32(1), 5-16

Berg, Frances M. (2004). Underage & Overweight: America’s Childhood Obesity Crisis – What Every Family Needs to Know. Preventing Chronic Disease Public Health Research, Practice, and Policy, New York:Hartherleigh Press 464 p

Kristen, R. Howard. (2007). Childhood Overweight: Parental Perceptions and Readiness for Change. The Journal of School Nursing, 23(2), 73-79

Armstrong, M E G, Lambert, M I, Sharwood, K A, Lambert, E V, (2006). Obesity and overweight in South African primary school children – the Health of the Nation Study. 11(2), 52-64

Steyn, N P. (2005). Managing childhood obesity: a Comprehensive Approach. CME 23(11), 540-543

Goedecke, Julia H, Jennings, Courtney L, Lambert, Estelle V. (1995-2005) Obesity in South Africa. Chronic Disease of Lifestyle 65-78

Ben-Sefer E, Ben-Natan M, Ehrenfeld M, (2009). Childhood obesity: current literature, policy and implications for practice. International Nursing Review 56, 166-173

Saunders Karen L, (2007). Preventing obesity in pre-school children: a literature review. Journal of Public Health 29(4), 368-375

Van Staveren, T and Dale, D (2004). Childhood Obesity: Problems and Solutions. JOPERD 75(7), 44-49

4 RESEARCH TITLE

A good title should give insight into what (what was done), whom (it was done to) and how (it was done)

Vitale, E. (2010). A School Nursing approach to childhood obesity: an early chronic inflammatory disease. Immunopharmacology and Immunotoxicology, 32(1), 5-16

What (was done)

A School Nursing Approach

Whom (it was done to)

Children with Obesity

How (it was done)

As a Nursing Approach – can be observation or questionnaires

The titles of the articles reviewed communicate an intent and findings of the research that was done for the articles.

All the articles reviewed titles were specific enough to describe the contents of the research that was done, but not so technical that only specialists will understand it.

The titles also describe the subject matter of the article e.g. a school nursing approach to childhood obesity: a chronic inflammatory disease.

All the above mentioned literature research title’s were very concise and descriptive.

The title’s also prick me as reader and motivated me to read the whole article.

PURPOSE

To discuss the current literature in relation to childhood obesity and to provide health practitioners, especially nurses, with the fundamental knowledge that is imperative in the recognition of children who are at risk and thereby tailor appropriate interventions.

KEYWORDS

The following words was used as keywords throughout the articles that was reviewed:

childhood obesity, obesity, overweight, nursing, nursing program, chronic disease

The terms “obese,” “overweight,” and “at risk for overweight” have not been used

consistently in the research literature regarding children and adolescents. Children and

adolescents identified as overweight have a body mass index (BMI) at or above the 95th

percentile of the sex-specific BMI-for-age growth charts

DEFINITIONS

Childhood Obesity

Is defined as having a Body Mass Index (BMI) greater as the 95th percentile.

BMI = weight in kilograms ÷ height in meters2

The BMI of an individual is correlated to the total body fat and percentage body fat.

Overweight in childhood

According to the National Center for Health Statistics (NCHS), overweight in childhood is defined as having a body mass index (BMI) at or above the 95th percentile, based on the current growth chart designated for each gender.

Overweight

Overweight is generally defined as an excess of body mass (in practice this is mostly body fat), whereas obesity is defined as an abnormal excess of body fat. For this reason, the Centers for Disease Control and Prevention (CDC) uses the terminology “extreme overweight” instead of “obesity” when estimates are based on relative weight indices (like the Body Mass Index, see below) rather than on direct measurement of body fat.

Obesity

Obesity is when there is too much body fat other than the fat tissue in our bodies. It is also defined as an excessively high amount of body fat or adipose tissue in relation to lean body mass.

RESEARCH PROBLEM

Childhood obesity is a worldwide spread chronic disease. There are many factors contributing to this chronic disease e.g. genetics, environment,metabolism, lifestyle and behavioural components.

Overweight or obesity during childhood in most of the industrialized world, a childhood obesity epidemic is evident, with the numbers rising each year.

Obesity impacts many lives: male and female of all ages, races, economic background, and education status

Why is obesity a chronic disease?

Obesity is associated with high blood cholesterol, complications of pregnancy, menstrual irregularities, hirsutism (presence of excess body and facial hair), stress incontinence (urine leakage caused by weak pelvic-floor muscles), psychological disorders such as depression and increased surgical risk.

It affects more than a quarter of the American population. Obesity may also causes other serious medical conditions e.g. cancer, heart diseases, diabetes, etc.

LOGIC ARGUMENTATION

Examining the work of the the above mentioned authors on the childhood obesity issue, there are a genuine challenge to achieving, legitimate, cost-efficient progress on childhood obesity. And if we are honest about why the childhood obesity problem needs to be at the

top of policymakers’ agenda, the most compelling answer comes back to money.

It is a serious medical disease that affects over a quarter of adults in the United States, and about 14% of children and adolescents. It is the second leading cause of preventable death after smoking.

Berg makes a compelling and convincing argument that “the dangers of childhood obesity are real” by highlighting the increased risks overweight and obese American children face for obesity-related health problems such as type 2 diabetes, hypertension, and psychological disorders. She notes, for example, that from 1979 to 1981, the annual hospital costs related to obesity among children and adolescents were $35 million; from 1997 to 1999, these costs rose to $127 million.

Evidence from the literature provides proof of Berg’s claims about the reality of the dangers of childhood obesity and further supports her reasonings that American society must take responsibility to “reclaim the health of generations to come.”

There are many arguments that obese children will be stigmatized and that this will increase bullying, as well as leading to an increased number of children suffering from eating disorders in the future. A number of people In addition, feel that parents should be able to tell that their child is overweight and that the money could be put to better use by doing something to help change the situation.

Many consider obesity an individual matter. However, children cannot be accountable for their weight. The children have little knowledge about the anatomy of their bodies. Children will keep eating if they see that junk food is advertise all over and ok. There are two main arguments on this issue: 1) Child obesity is mostly caused by food advertisements, and 2) Parents are not doing their jobs.

Some argue that children are growing obese, because of the exposure to food advertisements. They believe that the government should step in and regulate food advertisements on children.

A child becomes obese not because he or she watches advertisements, but because they sit in front of a television all day with no exercises or any other physical activities. In addition, it is believed that the schools as well as government is obligated to fix the epidemic. The generation has a major problem that will result in statistical records of people with heart disease, high blood pressure, and diabetes. A solution to the epidemic can be the corporation between parents, the industries, and the government.

Dr. Peter Nieman, (2004) a practicing pediatrician, has identified three main causes of childhood obesity: genetics, overeating and lack of exercise. He emphasizes that it is important to understand that the causes of obesity are often a combination of these three factors. Obesity if just not the result of a single factor.

As the government becomes more aware of the serious problem of childhood obesity, schools in the UK are now planning to weigh and measure all children at the ages of

4-5, when they start primary school and again at 10-11, when they are about to leave for secondary education.

Van Staveren.and Dale’s (2004) article: Childhood Obesity: Problems and Solutions

discusses the problems related to the epidemic of Childhood Obesity. There are many problems that could have led to this epidemic but in their article, they only discuss the main four problems.

The Authors feel that the following are the main causes for Child Obesity:

Unhealthy food in schools

No policies on good dietary in schools

Unhealthy food in family life and

A Lack of family responsibility towards children regarding their diets.

There are many arguments that obese children will be stigmatized and that this will increase bullying, as well as leading to an increased number of children suffering from eating disorders in the future.

A number of people, feel that parents should be able to tell that their child is overweight and that the money could be put to better use by doing something to help change the situation.

Being parents, most of the people ask what they can do to help their children keep their weight under control.

Parents can set a good example by providing healthy nutritious meals and not eating junk food themselves, but it is important to allow some treats, as being over strict is likely to cause friction.

If the whole family learns about healthy nutritious eating and try cooking new healthy recipes together, kids won’t feel they are being singled out. It is also very essential not to focus too much on food. Although it is an important part of life and can never be avoided, it should not be made the main topic of discussion in the family.

If the overweight children are constantly reminded of their weight and what overeating can do to them, they could develop an unhealthy attitude towards food. So the parents must be sure to focus on other things, certain areas of life which are not stressful and which their child enjoys as well as good activities with the children e.g. jogging all together as a family in a park.

People might believe that children eat no more calories than children 20 years ago. The fact is that, the increasing obesity rates are likely due to a combination of changes in both eating and exercise habits. Although the increase in calories has been difficult to define due to imperfect assessment methods, it has become very clear that children eat much more processed starch and sugar especially in the form of soda coldrinks and other sugary drinks than in past years.

Parents often need to compromise or negotiate with children in regard to their food intake, and teenagers certainly make many of their own food-purchasing decisions on the basis of, in part, advertising. Marketing food to children dramatically worsened their nutritional intake.

The issue on obesity continues to grow everyday, especially in newer generations. Many are saying generation x and future generations as well are going to be the only generations that are not going to outlive their parents.

Childhood Obesity is a major contribution to these assumptions, it causes diseases and many other health problems.

Dr William J. McCarthy uses logical argumentation with his audience by saying many children in this generation are becoming over weight.

During McCarthy’s interview in the video Project 1a, he tries to warn parents as well and, with the use of pathos, (Pathos is a communication technique used to represents an appeal to the audience’s emotions ) by frightening parents into believing their child is at a high risk of a disease. He states, they are “starting to see diseases, which were really unheard,”

This causes parents to worry about their children and want to reduce the risk of them obtaining a disease. After hearing these facts parents may help their children eat healthier so they are not overweight and have a less chance of obtaining a disease.

CONCLUSIONS

From this review, it is apparent that obesity in South Africa is a growing problem in all sectors of the community, yet a particular challenge in children and urbanised black women. To address this problem and the associated morbidities in South African communities, a multi-sectoral approach is needed.

This should include changes in policy aimed at creating an environment conducive and supportive for change, such as the promotion of physical activity and dietary education in schools. In addition,

The opportunity for primordial prevention of obesity, particularly in children, should be promoted.

These prevention strategies should be culturally sensitive and encompass programmes to improve the Education, status and economic empowerment of women.

This assignment highlights the strengths and weaknesses of the systematically reviewed literature relating to the prevention and treatment of childhood obesity. Prevention is not realy discussed in the existing literature and no specific approach to intervention can be recommended. As prevention is generally considered the most effective, economical and socially acceptable approach to addressing the “obesity epidemic”, the need for clear principles upon which to base prevention strategies must be considered an urgent research priority.

The reviewed literature can provide an evidence-based framework for preventative interventions. It is clear that preventative programs should include strategies to address diet, physical activity and behavioural change.

With the development of guidelines in school health care the authorities should have a better understanding for the optimal spending of public money for the sake of the health of the childhood

With the development of a guideline on the prevention of overweight and obesity in childhood representatives of school health care in three European countries (i.e. Croatia, flanders and slovenia) can use the same methodology in order to elaborate common evidence-based recommendations for school health services in their countries. On top of these common recommendations, some specific advices were added in accordance with the organisation of health care and school health care in the respective countries.

Any country that has a high rate or increasing rate of childhood obesity must acknowledge core factors that contribute to this serious health problem. Furthermore, public policy and community involvement that include all health professionals have a responsibility in the prevention of childhood obesity. This can be implemented through education, research and advocacy of all nurses involved with children and families.

Guidelines on school health care aim at increasing the effectiveness, efficiency and quality of the preventive health care as it is delivered to school aged children and adolescents. They should contribute to a better health, growth and development of children, on an individual as well as on a population level.

After being informed about the principals of the guidelines, parents and children should have a clearer idea about what to expect from the school health service, and become more conscious of their own and their children’s health.

Any country that has a high rate or increasing rate of childhood obesity must acknowledge core evidences that contribute to this serious health problem. This can be implemented through education, research and health education by all the nurses involved with children and families.

Obesity effects thousands of Americans every year. In order to maintain a healthy weight and stop the spread of this chronic disease is by exercising and eating a balanced

diet.

Don’t become a victim of such a deadly disease!